Parkinson's disease and how it affects you

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Parkinson's disease is progressive neurological condition, it doesn't directly cause people to die, but symptoms do get worse over time.

Parkinson's disease affects one in every 500 people, which equates to about 127,000 people in the UK.

Although most people with Parkinson's start to develop symptoms after reaching 50, around 1 in 20 people experience symptoms when they are under 40. This is known as early-onset Parkinson's disease.

Diagnosis of Parkinson's disease can be very upsetting, however, most people stay reasonably active living with the condition.

For some people, the illness is debilitating as it progresses, and they will need help with washing, eating and dressing.

It is thought between 50 and 80 percent of people with Parkinson’s disease will go on to develop Parkinson's dementia (10-15 years post diagnosis).

Planning for the progression of Parkinson's is something that should be considered both for yourself and the benefit of your loved ones. You may find your affairs need to be managed by someone you trust as the illness advances.

Causes

Parkinson's disease is caused by low levels of the chemical dopamine in the brain. Dopamine is a chemical messenger (neurotransmitter) which makes other parts of the brain that coordinate movement work properly.

The level of dopamine in the brain is linked with the levels of other chemicals, including acetylcholine. Low levels of dopamine and changes in acetylcholine and other chemicals cause the symptoms of Parkinson's disease.

Symptoms of Parkinson's disease

The symptoms of Parkinson's disease often start on one side of the body first and then affect both sides.

The main symptoms are:

·         Shaking - usually one of the first symptoms and affects most people with Parkinson's disease. It often starts in the hand and then usually affects the arms and legs, but sometimes also the head and jaw;

·         Stiffness - difficulty moving the limbs;

·         Slow movement - people with Parkinson's disease often walk with a slow shuffle;

·         Problems with posture and balance;

·         Speech may become quiet or rapid;

·         Loss of facial expression;

·         Small handwriting;

·         Depression and anxiety;

·         Bowel and bladder problems - constipation and the need to urinate often;

·         Impotence;

·         Increased saliva and sweating;

·         Sleep problems and tiredness.  

Diagnosis of Parkinson's disease

If your GP thinks you might have Parkinson's disease, he or she will refer you to a neurologist or a geriatrician.

There is no single test for Parkinson's disease. Diagnosis is based on identifying the Parkinson's disease symptoms and ruling out their cause by other conditions.

Blood tests and scans can be used in this process.

Some medications, including those used to treat mental illness, can have side effects that produce symptoms similar to Parkinson's disease (Parkinsonism).

If diagnosed with Parkinson's disease, you should see the specialist doctor once or twice a year.

Treatment

Treatment is aimed at restoring the levels of dopamine in the brain and controlling symptoms.

The symptoms and progression of Parkinson's disease are different for each person. Your doctor will help you to decide which treatment is best for you depending on your symptoms and needs.

Medicines

Medicines that replace dopamine are the most effective treatment. These are combinations of levodopa, which breaks down to form dopamine, and a chemical that delivers levodopa to the brain.

There are some side-effects such as feeling sick, vomiting and sudden drowsiness.

They can also cause long-term problems such as involuntary movements of the face and limbs.

Over time these medicines may become less reliable, with symptoms suddenly fluctuating.

Dopamine agonists are medicines that mimic the action of dopamine.

They are usually taken with levodopa or before using levodopa. Side-effects of dopamine agonists can include feeling sick, constipation, headache and sudden sleepiness.

COMT (catechol O-methyl transferase) inhibitors are a new type of medicines that stop the breakdown of dopamine.

These are used with levodopa and are usually given when the patient has had Parkinson's disease for some time and when dopamine replacement medicines start to lose their effectiveness. They can affect the liver.

Amantadine acts like a dopamine replacement medicine but works on different sites in the brain. It has few side-effects, but is only used in the early stages of the disease.

Surgery

If medicines are no longer helping, deep brain stimulation may be suggested.

This is when electrodes are placed in the brain in the areas important in controlling movement. They are connected to a pulse generator placed under the skin of the chest.

Tiny electrical currents sent from the pulse generator to the brain may reduce symptoms of Parkinson's disease.

Other therapies

Other therapies for managing and coping with Parkinson's disease include physiotherapy, speech therapy and occupational therapy.

Further information

Parkinson's UK, formerly The Parkinson's Disease Society, is the UK's leading charity helping and supporting people with Parkinson's, their families, friends and carers.

It funds and assists research and specialist nurses. It also supports and provides resources for health and social care professionals.

 

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